LAGUNA HILLS - Emily Lucero was grateful she didn't have to repeat her symptoms to every doctor and nurse who came to check on her as she lay in her hospital bed at Saddleback Memorial Medical Center.

"You just want to get help," said the 26-year-old Lake Forest resident, who had a blood clot. "You don't want to keep retelling your story. … It made me comfortable that they knew what was going on with me."

With a few clicks on a keyboard, Lucero's caregivers had access to her medical files. They could read notes from other medical staff, her health history, doctors' instructions and find out what medications Lucero might be taking or have allergies to.

While some hospitals have a portion of their patient records and ordering systems computerized, Saddleback Memorial is the first hospital in the county to have a comprehensive, nearly paperless system that physicians routinely use, said Scott Joslyn, MemorialCare's chief information officer. MemorialCare's other four hospitals will follow suit.

Trade organizations do not track this information, but Jim Lott, executive vice president of the Hospital Association of Southern California said Saddleback Memorial is one of a handful in the state to have a fully integrated system.

Doctors can electronically order lab tests and prescriptions, greatly reducing the risk of transcription errors as hospital staff try to decode doctors' handwriting. Prescriptions orders are then immediately checked for crossover interactions and allergies.

It's much easier than thumbing through stacks of paper medical files and trying to track down patients' clipboards with handwritten - often illegible - notes, hospital staff say.

Quick access

Gone are the days of monstrous medical files and scribbled prescriptions. Saddleback Memorial in late July began using Electronic Health Record. Computer stations are located throughout the hospital on wheeling carts, giving doctors quick access to patients' medical files.

"The typical doctor is so rushed with a zillion things going on that they scribble out a prescription. Then someone else is trying to guess what they've written down," said Dr. David Lagrew, the hospital's chief of staff. "And that's how errors occur."

The new system will help prevent errors such as these, Lagrew said.

A 1999 report released by the Institute of Medicine revealed that up to 98,000 people die nationwide in hospitals each year because of medical errors. A conservative estimate of 7,000 of these cases are due to medication mix-ups, the report said.

"Lives are lost because of errors," Lagrew said. "We took this statistic to heart and began making plans to resolve it."

Reducing risk

The trend toward paperless files is spreading as the government calls for increased patient safety. At nearby Mission Hospital in Mission Viejo, a portion of patient records are kept electronically. The hospital is working in stages to move all patient information into one computer system.

Western Medical Center Santa Ana, and affiliates Western Medical Center Anaheim, Chapman Medical Center in Orange and Coastal Communities Hospital in Santa Ana, will also eventually go paperless, said Western Medical Center Santa Ana spokeswoman Shelle Malm. The corporation is currently reviewing systems, she said.

A report released last month by the Institute of Medicine calls for all prescriptions to be written electronically by 2010.

On average a hospitalized patient is at risk to at least one medication error per day, the report says. And this could cost hospitals up to $3.5 billion a year.

"The numbers are big. The injuries are big. This is a problem, it's serious and it continues," said the report's co-author Michael Cohen, president of the Institute for Safe Medication Practices, according to an Associated Press story.

Learning a new language

With the new system, Lagrew said he has already seen an improvement in patient care. His patient rounds to high-risk pregnancy mothers have become more efficient. He is no longer searching for patient clipboards or trying to stop a doctor in the hall to catch up on a patient's progress.

"It gives you a complete picture of the patient," Lagrew said. "Right there in front of you."

Although there have been a few hiccups and "meltdowns," Lagrew said staff is adjusting well.

Less than five prescriptions of an estimated 3,000 per day are now done by hand, he said.

"Handwriting medical files is a practice that's been going on since the 1920s," he said. "Some of these doctors didn't even know what a mouse click was. This is like learning a new language. That they have come this far is a remarkable thing."

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